Pointed questions


It seems that President Trump and President Xi Jinping are best buddies again after mending fences at the G-20 summit in Osaka. They both want to defuse the tit-for-tat trade war which threatens the economic stability of the world economy. "We're right back on track and we'll see what happens," says Mr Trump, although that is not exactly the language of iron-clad guarantees.

The link to bioethics?

Well, it is a bit tenuous, but I’m disappointed that Trump did not bring up China’s egregious human rights abuses. If “egregious” seems offensive, how about flagitious or abhorrent? We’re talking about putting a million Uyghurs in concentration camps because they are Muslims. Some members of the United Nations have fewer than a million people.

And it appears that some of them, along with the persecuted Falun Gong sect, are being quarried for their organs. An article appeared in Nature this week reporting the results of a private investigation. It concluded that “forced organ harvesting is of unmatched wickedness even compared – on a death for death basis - with the killings by mass crimes committed in the last century.”

Is the evidence incontrovertible? No, probably not. But that’s why Trump should have asked some pointed questions.

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Underneath the mask


This week Governor Andrew Cuomo threw in his cards, beaten in his attempt to pass a law legalising commercial surrogacy in New York. He was furious. “I say, how about a woman’s right to choose, which we just argued for Roe v. Wade?” Cuomo said in exasperation. (See article below.

The thing is, Governor, the women did choose. They chose to oppose a bill which would exploit them. And it wasn't just the religious types. Deborah Glick, the first openly gay person to sit in the state assembly, said that Cuomo was not being respectful. “I certainly do not think that there is sufficient protection for the women who do not appear to be considered as people in the arrangement, but rather as the donor and as the surrogate.” 

She is not alone. The president of the National Organization for Women said: "Commercial surrogacy does not depend on the willing choice of friends or family to help loved ones, instead it relies on the commodification of women’s bodies. History has shown us that the buying, selling and renting of their bodies does great harm to women."

It appears that Cuomo has failed to deliver on a promise to gay men to legalise commercial surrogacy so that they can rent the wombs of needy women. When push comes to shove, a new, rainbow-coloured patriarchy is just as ready to exploit women, feminists included, as the old patriarchy. 

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Russian biologist to create gene-edited human embryos


LATE FLASH -- sorry to all of our readers. We have finally discovered and destroyed the bug in our software. Thanks for your patience. 

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Outrage over Russian plans to edit human genome


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Vale Noa Pothoven


The news of a 17-year-old Dutch girl suffering from anorexia nervosa who died of 'euthanasia" flew around the world this week. It was an error. The Royal Dutch Medical Association (KNMG) clarified what happened: "She decided to stop eating and drinking to bring her own death. In The Netherlands, this is not considered euthanasia or physician assisted suicide." The media issued corrections and moved on. 

I'm curious to know more about this sad story. In her autobiography, Noa said that she had been raped and that this had provoked a psychological crisis. Sadly, this could easily have been true. No one queried the truth of her story, possibly because sexual abuse is known to trigger anorexia. But without that back story, would the world have been so sympathetic to her decision to starve herself to death?

The KNMG says that stopping eating and drinking under medical supervision is not physician-assisted suicide. Really? She committed suicide and she was assisted by physicians. As Humpty Dumpty said, "When I use a word, it means just what I choose it to mean—neither more nor less." If Noa's death wasn't physician assisted suicide, then I'm a Dutchman.

Isn't the real news here something altogether different? Dutch doctors who were unable or unwilling to treat a 17-year-old rape victim for anorexia nervosa gave up on her and allowed her to kill herself. In her time of greatest need, they abandoned their patient.  

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Black genocide


An interesting group within the American pro-life movement is African-Americans who oppose abortion. The Rev Clenard Childress Jr, for instance, is a New Jersey pastor who runs a website called Black Genocide. Groups like his highlight the fact that African-American women account for a third of abortions in the US. 

This might have been remained a factoid about the US abortion wars, but it was unexpectedly placed on centre stage this week with the Supreme Court's decision in Box v. Planned Parenthood of Indiana and Kentucky. Justice Clarence Thomas, the only African-American on the bench, was seething with anger when he reflected on the fate of black babies (see our story below): 

abortion in the United States is also marked by a considerable racial disparity. The reported nationwide abortion ratio— the number of abortions per 1,000 live births—among black women is nearly 3.5 times the ratio for white women. And there are areas of New York City in which black children are more likely to be aborted than they are to be born alive—and are up to eight times more likely to be aborted than white children in the same area.

Journalists who bothered to report his remarks shook their heads and described him as loopy. He's not. That abortion has a disproportionate impact on the poor and disenfranchised is a blot on American society. For a touching comment on this, check out this rap song from a group called Flipsyde, Happy Birthday. 

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How to make comments


We cover a wide range of issues in this newsletter, ranging from whether brain-damaged Frenchman Vincent Lambert should be allowed to die to whether IVF affects human evolution.

But today I’ll address a nuts-and-bolts issue– how to make comments. We’d like to encourage debate and fresh ideas in the comment box below each article. However we realise that it is a bit clumsy and hard to use.

There are no perfect commenting systems. We use third-party software called Disqus. It works well and allows us to moderate comments. But the best way to make a Disqus comment is to sign up for Disqus. It’s easy and quick.

Unfortunately – and understandably – many of our readers are reluctant to sign up for one more social media system. The solution is to post as a “guest”. But Disqus makes this a bit difficult.

So here’s how to do it. Type your name (or pseudonym) into the “name” box. Then two more boxes appear. Type in your email AND tick the box “I’d rather post as a guest”.

Voilà! You’re all set. Write your comment (be sensible and polite) and click the arrow button.  

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A world of paradox


Being just a bleachers bioethicist, I don't have anything original to contribute to the debates. I just watch from the sidelines. However, one thing that does strike me is the number of situations in which the received wisdom leads to contradictory or paradoxical conclusions.

For instance, some doctors argue that the use of performance-enhancing drugs is wrong because it gives athletes an unfair advantage over "natural" athletes. But South African Olympic champion Caster Semenya has been ordered to take performance-reducing drugs because her natural endowment makes her too fast. 

As you can read below, an Ontario appeals court says that doctors who refuse to refer for voluntary euthanasia (killing their patients) should be drummed out of medicine. In the UK, meanwhile, a tattooist has been jailed for 40 months for voluntary tongue-splitting

And last week a judge in the UK gave his blessing to an unnamed couple who are allowing their 4-year-old son to socially transition to a girl. Four years old seems a bit young to make up one's mind about gender. On the other hand, the Belgian medical association has demanded that parents who give their 4-year-olds a vegan diet be prosecuted.

It's all a bit bewildering. 

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Is it possible to wind back euthanasia in Belgium?


In our lead story today we focus on an apparent, and surprising, rift over euthanasia in Belgium. On the one hand the medical association recently issued guidelines which tell doctors to be more cautious about granting euthanasia for psychiatric reasons. On the other, the country’s leading right-to-die association is campaigning vigorously to grant euthanasia to patients with dementia. Apparently, even supporters of the country’s euthanasia law differ on the wisdom of making a liberal law even more liberal.

My feeling, however, for what it's worth, is that Belgium will keep relaxing its 2002 law until it becomes effectively euthanasia on demand. Doctors will become mere suicide enablers.

There may be one way to stop this process, or at least to slow it down. And that is to fire the chairman of the Federal Euthanasia Commission, Dr Wim Distelmans. This gentleman is not only the senior regulator of euthanasia in Belgium. He is also a media star as the chief spokesman for the right to die and one of the main practitioners of euthanasia. In other countries, this would be regarded as an egregious conflict of interest.

A new chairman who is not immersed in the world of Belgian euthanasia politics would be in a better position to identify abuses and refer doctors who fail to comply with the law to the public prosecutor. 

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New stats on Dutch euthanasia


The government's statistics for euthanasia in the Netherlands were released recently. They show that the number of people who took advantage of legal assisted suicide and euthanasia declined slightly -- about 7% -- for the first time since 2006.

To be completely candid, I regard a decline in the number of euthanasia cases as good news. That is, if it is true. It is possible that more cases were simply not reported to the authorities. Fewer euthanasia cases means fewer people in desperate pain and fewer people who feel that their lives are meaningless.

However, this is not the way that euthanasia supporters see it. For them it was bad news because fewer people had taken advantage of the blessing of a peaceful death. From their point of view, good news is an ever-increasing, upward-sloping line on a graph. 

Euthanasia already accounts for at least 4% of all deaths in the Netherlands. What proportion are its supporters aiming at? 5%? 10%? 40%? I have never read any projections of this figure. It would be interesting to know what the future holds for the Dutch. 

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